Diabetes Mellitus and Risk of Skeletal Fracture

THERE is considerable evidence that many people with diabetes mellitus of either juvenile or adult onset have moderately reduced bone mass (osteopenia).^{1 2 3 4 5 6 7 8 9 10 11 12 13 14} For example, Levin et al.¹⁰ measured bone density by photon absorption in the forearms of 136 diabetics with various clinical characteristics and found reductions in bone mass that ranged from 10 to 20 per cent below means for appropriate controls. The decrements were not much different in juvenile-onset diabetes as compared with adult-onset diabetes; in fact, the greatest reduction was in patients with “mild” adult-onset diabetes treated with oral agents.¹⁰ Some investigators have suggested that persons with uncontrolled.